Extract from the CBTandFeelingGood.

com w orkbook - Veronica W alsh

Understanding Fight or Flight (our physical response to stress)

Evolution produced us: todays fabulous human beings. But there are a few design flaws. And some
primitive responses weve been saddled with that often do more harm than good these days. But we can
learn to understand and control them with CBT

What is fight or flight? When we perceive a threat, our bodies go into

fight or flight mode in an instant this physical response was developed
during evolution to help us survive the sabre-toothed tiger, or that
troublemaker that was trying to oust us from the tribe, or indeed anything
that threatened our survival.
Fight or flight is an instant pumping up of our bodies (with a series of physiological
changes) that better equips us to fight hard or run fast from danger it prepares us for
extreme physical action in an instant.
Here are a couple of examples that will explain the immediacy and effects of fight or flight:

You walk over to your lovely bowl of fruit. Reach in, and OH! a big
SPIDER! EEK. The natural reaction is to jump back our bodies instantly
revving into fight or flight, our hearts thump, our stomachs tighten into a knot
etc. But within a few moments, we (well most of us) realise there is no
extreme danger here and our bodies return to a natural balance very quickly.

Youre in bed. Youre woken by a crash sound somewhere in your

home. A BURGLAR!?! You are instantly alert you spring up, tilt
your head back, eyes focussing in the middle distance for danger, ears
straining to hear whats going on, your heart pumping and lungs
expanding to take more oxygen, heat rising in your body, ready to
take whatever action is required (this can include freezing which
protected us from notice of predators etc) then your flatmate shouts
in sorry, only me, I dropped a plate. Deep sigh as your body returns
to balance and calms down

Those are examples of real practical problems that would benefit from fight or flight after all, if you
had to deal with a giant tarantula or a violent intruder, you would make good use of your body in its
prepped and revved up state, right? And in both cases, within a very short time, we realise there has been
a mistake in processing the event, an irrational cognition, and our body returns to balance (homeostasis)
very quickly. But many of us fight invisible tigers constantly imagining dangers and threats where
there are none, which brings on our flight or flight even when there is no real danger present. This is at
the very least uncomfortable, and at worst results in regular panic attacks and ongoing physical illness.
So danger is often psychological rather than physical. Situations only bring on fight or flight if
you perceive them as dangerous - its often not the situation itself (an interview, public speaking, a party,
being chatted up, etc) that makes your body sick and shaky, its how you think about it. We can use CBT
to recognise that our thinking causes us to see these metaphorical tigers and we can learn healthy new
thinking that banishes them and lets us relax and enjoy our life and opportunities and experiences.
But for the purpose of this exercise let us just look at the physiology of fight or flight here as it is
shown to help people better manage the situation if they understand, scientifically, exactly what is
happening and why. Understanding that fight or flight is a natural bodily reaction with a beginning, a
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middle and an end and that it is actually a sophisticated elaborate chain developed to help and protect
you can be hugely helpful. This learning can make it so that it happens less often and with less ferocity.
If you have anxiety (or are a worrier), the chances are that you are fearful of many things, with the flight
or flight hormones constantly simmering within, which may cause general fatigue, confusion, and ill
health this would also contribute to self-limiting decisions and behaviours, and would of course
reinforce a negative view of the world.
We can challenge and relearn our behaviour and responses to stress triggers by restructuring our
thoughts in a more rational and healthy way but we also need to be aware of why we are
physically feeling the way we are this can help us to stave off panic and remain reasonably calm.
Task: draw a silhouette of a body and arrow physical symptoms youve experienced
(Flip-chart exercise)

....howandwhyitshappening:
Thoughts racing and disjointed caused by
an adrenaline release.
Dizzy / lightheaded due to adrenaline and
increased oxygen levels.
Surroundings seem distant or visual
tunnel your pupils dilate to allow you to
take in as much visual information as possible.
Eyes refocus to the distance to spot danger.
Heart pounding The heart starts beating
faster to increase circulation, since the body
anticipates it will be working harder to service
the muscles.
Difficulty breathing - the lungs throat and
nostrils open up to flood the lungs with
enough oxygen to keep up with the increased
circulation of blood (re-oxygenating it) this
can trigger shallow rapid breathing.
Neck and shoulder tension caused by oxygen pumping to muscles/after effects as oxygen reduces.
Blushing Adrenaline causes your blood vessels to dilate in order to improve blood flow and
oxygen delivery. As a result, the veins in your face dilate, allowing more blood to flow through them.
Sweating The body heats up because it is working harder to circulate blood. And then sweats so it
can cool itself down / regulate temperatures.
Butterflies/sick feeling Cortisol shuts down your digestive system, (as it is not needed to fight or
run), redirecting blood to essential systems such as the heart, lungs, legs and arms. This can also
cause irritable bowel syndrome, nausea and diarrhea
Dry Mouth - Cortisol shutting down inessential systems reduces saliva in the mouth.
Need to urinate (and maybe even pass a stool) - The bladder and bowels may open out to reduce
the need for inessential internal actions (and faeces & urine may have put off our attackers)
Trembling, wobbliness, tingling and shaking effect of adrenaline stimulus and oxygen overload.
Tightness in the chest and throat, difficulty breathing the body is overloading on oxygen
which is dangerous if you do not burn the extra oxygen off. Therefore the body tries to reduce the
levels by constricting the chest and the lungs, reducing breath intake

Task: match the previously arrowed symptoms to the above points and see whats happening?.
Memorise the things that happen and why... expect them, respect them, let them pass....
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YEAH YEAH BUT, WHAT THE HELL WILL I DO?!

It is common that some people feel even more anxious and scared when
these physical effects of fight or flight kick in (they start out feeling
anxious about the situation, then they get the physical symptoms and
are freaked out by them as well which accelerates and amplifies the
symptoms up to an actual panic attack). For some, it becomes the fear
of the physiology itself that causes a major and ongoing social fear
issue (blushing, sweating, breathlessness). Attempting to fight against
the physical manifestations of anxiety almost always has the opposite
effect and intensifies them. Try instead to simply let them happen
try to observe outside of yourself tell yourself whats happening to
your body and why example:

This sweating is simply my bodies way of regulating its

temperature as its overheated because Im scared of this situation and Ive gone
into fight or flight it will stop as soon as I calm down Ill breath in and out
slowly and deeply I am ok, I can cope, this is ok

Summary: what is happening with a person who reacts with anxiety and inappropriate physical
symptoms is that their body is reacting to the situation as if were as dangerous as, say, a tiger or
lion approaching to tear them apart. A false perception has occurred, triggering a very basic and
automatic response. We can learn to challenge our perception of events, and because the fight or
flight response occurs only when we perceive danger, it can be avoided or minimized if we can
convince ourselves there is nothing to fear.
We can challenge and relearn our behaviour and responses to stress triggers by restructuring our thoughts
in a more rational and healthy way with CBT but we also need to be aware of how and why we are
physically feeling the way we are this can help us to stave off panic and remain reasonably calm.
Quick practical tips:
Deep breathing: because so many symptoms are caused by the oxygen/rapid breathing physiology
breathing control exercises are hugely helpful in easing them. You can link audio of a breathing exercise
on my blog and website.
Cardio exercise when you feel your body go into fight or flight jitters, do 5 minutes of physical
exercise if possible in the environment youre in (run up and down stairs, do sit upsanything
cardiovascular, something that makes you sweat!). The body has primed itself for something physically
dramatic (the fighting the tiger or running away very quickly..) and if you stay immobile it will be
confused and take longer to return to homeostasis the exercise will restore balance more quickly.
Relaxation choose deliberately to do something you find relaxing (movie, book, candles and music, a
walk in park, yoga, mindfulness, whatever) the body has a relaxation physical response, which
releases chemicals that reduce stress hormones, this slows your heart rate and lowers blood pressure and
relaxes muscles, returning you homeostasis (balance). You can link to an audio Guided
relaxation/breathing/visualization exercise on my blog/website www.CBTandFeelingGood.com.

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BEWARE CORTISOL in fight or flight (the stress hormone, or the death

hormone as its scarily called!) - Cortisol is a hormone that gets secreted when
we are under physical and/or emotional stress. No matter what the source of
stress, cortisol is released into the blood stream to help us cope, aiding our fight
and flight response by putting sugar into the blood stream so our muscles and
brain have the fuel needed to react.
Cortisol is generally high in the morning, but should subside by evening when our rest and repair system
(parasympathetic system) is supposed to take over and return us to metabolic equilibrium (homeostasis).
Or at least that scenario is the appropriate stress response by the body BUT, todays lifestyles and
challenges mean that more and more of us are in a state of high cortisol most of the time as our system
keeps us in a constant state of readiness for the perceived danger/threat of our stressors.
This is very dangerous to our health as cortisol curbs functions that are not essential for fight or flight,
which alters the immune system responses and suppresses the digestive system, the reproductive system
and the growth process. The long-term activation of the stress-response system and the subsequent
overexposure to cortisol and other stress hormones can disrupt almost all your body's processes. This
puts you at increased risk of numerous health problems, including:
Heart disease - Sleep problems - Digestive problems Depression Obesity (particularly depositing fat
around our middle section) - Accelerated aging - Memory impairment Skin problems etc.

This is why it's so important to learn healthy ways to cope with the stressors in your life
to help the body return to hormonal balance! Exercise, relaxation, CBT, visualisation, a
good diet, and reviewing how you live your life will all help start today!

Last note: these physical symptoms are natural, and designed to help us. Awareness of this can reduce
any negative amplification of fear and phobia, and teach additional self-management using rational
and calm consideration techniques. Think wow, look what my body is doing how amazing....

Relaxation and Visualisation techniques

It has been scientifically proven that visualisation and relaxation techniques can aid
in relieveng stress lets sit back and listen to an audio recording of a relaxation
script including visualisation methods (you can link to this from my
website!)

Audio task: 15 minute relaxation and visual exercise (requires, lights off, shoes too if you wish!)
(THIS AUDIO IS ON MY WEBSITE AT CBTANDFEELINGGOOD.COM)

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